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Need advice

I am 29 years old. 10 month ago I have diagnosed HB+.  In that time My status was:

  ALT: 35 U/L
  HBeAg: Negetive
  HBDNA: 30000 copies/mole

In this stage, I have started to take  Entecabir 0.5 mg daily as per Dr. suggestion. After six month I have tested ALT only and found 42 U/L

After 7 Month, I have tested HBDNA and found not detected. Finally 7 days ago I have tested ALT again  and  56 U/L . That means it is higher than previous ALT that was 42 (6 month ago

I am very much concerned with it since it is increasing day by day but Dr. said it is okay. Could you please suggest what can I do in this situation.


  
  
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Avatar_m_tn
ALT 35, 42, 56 do not necessarily indicate qualitative change.

Keep monitoring and be liver friendly.
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Avatar_m_tn
ALT 35, 42, 56 do not necessarily indicate qualitative change.

Keep monitoring and be liver friendly.
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Avatar_m_tn
alt only will tell nothing you need the full panel test, anyway as long as hbvdna is und the trouble is not from the virus but might be 2 things:

unhealthy diet, too much fat, over wheight, alchool, all things that can make the same damage to liver as hbv does

your immune system is killing all infected cells to get rid of most of the virus in your liver, to know if this is the case hbsag quantification is needed

i think the first option is the most probable and as long as hbvdna und just live a healthy life as cajim said
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Avatar_m_tn
Thanks for the kind reply. I believe I live liver friendly live. I never drink alcohol, no smoking and try to not eat unhealthy diet. I am not fat (W: 65 Kg H:  5.6 Feet). I walk 40 minutes everyday. The one thing that I am not maintaining is timely sleep. I am normally sleep at 2-3 AM cause I work from online in a USA software firm.

stefano170669 , could you please tell about the case hbsag quantification? I have also checked HBsAg which result index was  290 (out of 1)

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Avatar_m_tn
that's not quantification, it is reactive/non reactive qualitative test, quantification can be made by abbott architet only with unit in iu/ml
if you are liver friendly it might be virus left in the liver or hbvdna assay not sensitive enough, what is the lowest range detectable in your hbvdna test?

since you are hbe negative you might combo entecavir with alinia, see our posts about it.By alinia you will lower hbsag and maybe eradicate hbv, lower hbvdna to the lowest and prevent any possible resistance, of course hbv eradication by entecavir only is almost zero it can only control it
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Avatar_m_tn
Hi  stefano170669,

Thanks for the clarification. I will test hbsag quantification and let you know.

Just read your post about alinia. It seems all the post submitted by you even wiki post might by you and alinia is not well familiar for HBV. Could you give some good reference about alinia?

Thanks
Samir
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Avatar_m_tn

just put nitazoxanide or alinia in the search of hbv community and you will find all the links about alinia, it is too long to repost again, you will proably find all them in this long post too

the problem of all us hbv carriers is there is no drug effective on hbsag, only interferon is but very poor, and alinia looks like the most potent on hbsag (hbsag eradication means hbv eradication) in combo with entecavir or tenofovir or interferon (the most potent interferon combo and alinia combo from our small alinia group)
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Avatar_m_tn
post messed up again (looks like firefox doesn t work well with medhelp)

alinia looks like the most potent on hbsag used in combination with entecavir or tenofovir or interferon, from our small group experience the most potent combo is interferon+alinia or entecavir+alinia (alinia dose 1.5g or 2g daily, slower or no results on 1g daily)
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Avatar_m_tn
Got my lasted lab result but still found SGPT high. Result is:

SGPT: 62 U/L
HBDNA: Not Detected
Ultra sonogram: Normal

SGPT is going high day by day.  What will you expert guy say?

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Avatar_m_tn
Forgot to add one thing, bilirubin  is normal in range
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Avatar_m_tn
HBDNA: Not Detected
what is the sensibility?fo alt to be normal hbvdna must become less than 6iu/ml and most assays do not detect less than 20iu/ml

is your diet, wheight, life all healthy?

the most easy way to understand why alt is high is:
exclude bad diet, cholesterol, fat be the reason

exclude hbv by:
checking hbvdna by an assay with very high sensibility like 6iu/ml and at the same time check hbsag quantity and see if increasing or decreasing, in general alt gets at 30-40 range or lower after being hbvdna fully und for 2-3 months when etv or tnf therapy is taken
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Avatar_m_tn
Thanks for the reply. I have tested HBDNA at RanBaxy and they has shown the result less than 20 iu/ml. They did not tell the exact amount.

I am taking Entecarvir since 2009 October and first HBDNA undetected has diagnosed about 7 Month ago.

I believe my diet is healthy and I am not fatty. BMI is 24.1

Just one thing is, Normally I sleep at mid night(1AM -2 AM)  due to my profession.





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Avatar_m_tn
etv might be not strong enough to suppress hbv then.

you have 2 choices add tenofovir+entecavir and after a combo of at least 5-6months choose if to go on tnf monotherapy.tnf is more potent and has no resiatnce

or add nizonide500 (nitazoxanide) to entecavir

my experience:
i added ntz to etv this both to prevent resistance and boost hbvdna decline because at 5th nmonth of etv monotherapy it was still detactable, i was also hoping it was effective on hbsag lowering but at first i added to prevent resistance

after adding ntz decline was faster and i had less than 50iu/ml before 24 weeks, lower than 20iu/ml by 6th month and undetactable by 7th month

it just came back detactable to 21iu/ml when i lowered ntz in sep 2010 to 1g for a week since then i try to stay on 1,5-2g daily and nevr go lower than that
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Avatar_m_tn
also my alt are higher with ntz 1-1.5g (alt 40-45) and lower with ntz at 2g (31)

are you using generic entecavir from ranbaxy?
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